Saturday, January 20, 2018
Health

About that insomnia ...

Insomnia is like a thief in the night, robbing millions — especially those older than 60 — of much-needed restorative sleep.

The causes of insomnia are many, and they increase in number and severity as people age. Yet the problem is often overlooked during checkups, which not only diminishes the quality of an older person's life but may also cause or aggravate physical and emotional disorders, including symptoms of cognitive loss.

Most everyone experiences episodic insomnia, a night during which the body seems to have forgotten how to sleep a requisite number of hours, if at all. As distressing as that may seem at the time, it pales in comparison to the effects on people for whom insomnia — difficulty falling asleep, staying asleep or awakening much too early — is a nightly affair.

A 1995 National Institute on Aging survey of more than 9,000 people 65 and older revealed that 28 percent had problems falling asleep and 42 percent reported difficulty with both falling asleep and staying asleep. The numbers affected are likely to be much larger now that millions spend their presleep hours looking at electronic screens that can disrupt the body's biological rhythms.

Insomnia, Dr. Alon Y. Avidan says, "is a symptom, not a diagnosis" that can be a clue to an underlying and often treatable health problem and, when it persists, should be taken seriously. Avidan is director of the sleep clinic at the University of California, Los Angeles, David Geffen School of Medicine.

So-called transient insomnia that lasts less than a month may result from a temporary problem at work or an acute illness; short-term insomnia lasting one to six months may stem from a personal financial crisis or loss of a loved one. When insomnia becomes chronic, lasting six months or longer, it can wreak serious physical, emotional and social havoc.

In addition to excessive daytime sleepiness, which can be dangerous, Avidan says chronic insomnia "may result in disturbed intellect, impaired cognition, confusion, psychomotor retardation or increased risk for injury." It is often accompanied by depression.

There are two types of insomnia. Primary insomnia results from a problem that occurs only or mainly during sleep, like obstructive sleep apnea or restless leg syndrome.

The other, more common type of insomnia is secondary to an underlying medical or psychiatric problem; the side effects of medications; behavioral factors like ill-timed exposure to caffeine; or environmental disturbances like excessive noise or light in the bedroom.

Among the many medical conditions that can cause insomnia are heart failure, gastroesophageal reflux, lung disease, arthritis and Alzheimer's disease. Treating the underlying condition often relieves the insomnia.

Nonmedical causes of insomnia can often be treated by practicing "good sleep hygiene": limiting naps to less than 30 minutes a day, preferably early in the afternoon; avoiding stimulants and sedatives; avoiding heavy meals and minimizing liquids within two to three hours of bedtime; getting moderate exercise daily, preferably in the morning or early afternoon; maximizing exposure to bright light during the day; creating comfortable sleep conditions; and going to bed only when you feel sleepy.

If you still can't fall asleep within about 20 minutes in bed, experts recommend leaving the bedroom and doing something relaxing, like reading a book (one printed on paper), and returning to bed when you feel sleepy.

For those who still need help with insomnia, cognitive behavioral therapy has proved most effective in clinical trials.

Sleeping pills can be problematic, but over-the-counter remedies like melatonin or valerian, which have more anecdotal evidence than research to attest to their efficacy, are available.

There may also be some useful dietary aids, like bananas, cherries, kiwis, oatmeal, milk and chamomile tea, though evidence for these is also primarily anecdotal.

Comments
Expect some pain. Thatís what hospitals are starting to tell patients as concern spreads over opioids

Expect some pain. Thatís what hospitals are starting to tell patients as concern spreads over opioids

Doctors at some of the largest U.S. hospital chains admit they went overboard with opioids to make people as pain-free as possible, and now they shoulder part of the blame for the nationís opioid crisis. In an effort to be part of the cure, theyíve b...
Published: 01/19/18
Itís flu season, and how: Hereís what you need to know

Itís flu season, and how: Hereís what you need to know

Cristi Fryberger, a fifth-grade teacher, was headed back for the first day of classes at St. Petersburg Christian School after the Christmas break but didnít feel well. She left a couple of hours later and went to an urgent care clinic, where a swab ...
Published: 01/19/18
This 66-year-old is about to run seven marathons in seven days on seven continents

This 66-year-old is about to run seven marathons in seven days on seven continents

When Robert Owensís father was 75, he gave his son some advice. "He said, ĎYou know, son, the sad part is when you get old they just put you on a shelf and you become irrelevant. Fight to stay relevant. Fight to stay in the game, otherwise they will ...
Published: 01/18/18
5 things we learned about Trump from his medical checkup

5 things we learned about Trump from his medical checkup

Five things we learned about President Donald Trump from Navy Rear Adm. Ronny Jackson, the doctor who oversaw Trumpís first medical checkup in office. SLEEP Trump doesnít get much shut-eye. Jackson guessed that Trump snoozes four to five hours a nig...
Published: 01/17/18
A century after the 1918 pandemic, science takes its best shot at flu

A century after the 1918 pandemic, science takes its best shot at flu

WASHINGTON ó The descriptions are haunting. Some victims felt fine in the morning and were dead by night. Faces turned blue as patients coughed up blood. Stacked bodies outnumbered coffins. A century after one of historyís most catastrophic disease o...
Published: 01/17/18
A popular school fundraiser is just Ďjunk-food marketing to kids,í experts say

A popular school fundraiser is just Ďjunk-food marketing to kids,í experts say

For 43 years, schoolkids and their parents have clipped the labels from cookie bags and cracker boxes as part of a popular rewards program called Labels for Education.Through this and similar programs ó think Tysonís Project A+ or General Millsí Box ...
Published: 01/17/18
Pinellas is at the center of a rise in Florida flu outbreaks

Pinellas is at the center of a rise in Florida flu outbreaks

Feeling a little sniffly or scratchy or stuffed up? It may be the flu, and you donít want to wait around to see a doctor this year. This is not the time to write off flu-like symptoms, Tampa Bay area health officials and doctors warn. The influenza v...
Published: 01/16/18

CDC says ĎThereís lots of flu in lots of places.í And itís not going away anytime soon.

A nasty flu season is in full swing across the United States, with a sharp increase in the number of older people and young children being hospitalized, federal health officials said Friday.The latest weekly data from the Centers for Disease Control ...
Published: 01/12/18
Mease Countryside Hospital begins $156M expansion project

Mease Countryside Hospital begins $156M expansion project

SAFETY HARBOR ó Mease Countryside Hospital is launching a $156 million expansion to build a four-story patient tower with all private rooms and a four-story parking garage.The tower will include 70 private patient rooms, a 30-bed observation unit, cr...
Published: 01/11/18
Flu shot? This is why you should still get one this year

Flu shot? This is why you should still get one this year

This yearís flu season is shaping up to be a bad one. Much of the country endured a bitterly cold stretch, causing more people to be crowded together inside. The strain that has been most pervasive, H3N2, is nastier than most. And, weíre being told, ...
Published: 01/11/18